Cabinet Member: Cllr.
W. Gareth Roberts
To consider
the final report of the Alltwen Scrutiny
Investigation.
(Copy
enclosed)
Minutes:
Submitted - the final draft report
of the Alltwen Scrutiny Investigation
which outlined the work of the Investigation along with recommendations
to be submitted to the Cabinet Member
for Adults, Health and Well-being for further
action.
In the absence of the Chair of the Investigation, Councillor Selwyn Griffiths
took the opportunity to thank the members of the Investigation for their commendable work and also
in particular to thank those listed
on page 51 of the report, as well as Gareth James (Member Support and Scrutiny Manager)
and Bethan Adams (Member
Support and Scrutiny Officer). He drew the Cabinet Member's attention to the recommendations and specifically, asked him to secure
the service of a receptionist
to deal with calls during the integrated team's core working hours
at Ysbyty Alltwen.
The Cabinet Member also
thanked everyone who had participated in the Investigation and paid tribute and congratulated the staff of
the Health Board and the local authority
for this pioneering scheme, the outcomes of which had been very valuable. He welcomed and accepted the recommendations, especially the recommendation to extend the integrated working model across the County as he was of the opinion that this
should be the method of working in future. Some of the recommendations were operational ones and a number of the work elements to deal with these
matters were either already in place or
in the pipeline.
During the ensuing discussion the following comments were made:
(a) an explanation was provided of the fish bowl term, noting that it was a multi-agency
meeting with a specific structure including a nurse and physiotherapist, and that it
was a valuable way to consider solutions. However, it was not possible to hold one for
every case as it depended
on the timetable.
(b) In order for recommendation
4.1 to succeed, the need to
have a single computer system was emphasised, in order to record patient details so that staff from
the Health Board and Social Services could have access
to it.
(c) It was asked whether or
not it was intended to seek the opinion of the service users as
an attachment to the report.
(d) In response to the above, the
Alltwen Team gathered information and noted it on
the RAISE system. Also,
the procedure was based on a face-to-face
chat with the users and would also
seek the service users' opinion when undertaking reviews with everyone.
(e) A question was asked
about the response of the Health Board and
specifically were the
Senior Managers supportive?
(f)
In response, it was noted that they
were very supportive and the Regional Director - West, Betsi
Cadwaladr University Health
Board listed awards that had been won by
staff from the West region and from approximately
50 awards it was a pleasure to note the following winners:
·
Ffordd Gwynedd Team - Award for
A New Way of Working
·
Ysbyty Alltwen - Award for work
with Dementia
·
Ysbyty Dolgellau - Award for Implementing
Good Practice
·
Ysbyty Gwynedd Pharmacy - Award for Working Bilingually
·
Chief Nursing Administrator,
Children’s Ward, Ysbyty Gwynedd - Leadership
Award
(g) Many nurses were seen
taking notes when visiting patients
and then having to feed the information into a computer afterwards - was there any movement
towards changing this method of working?
(h) In response, the Area Manager for the Adults, Health and Well-being Department noted that whilst they
accepted that nurses continued to use diaries to take notes, that
they were also eagerly waiting
for a new system that could make
an important contribution towards reducing this.
(i)
For some months now, there had been high praise
for integrated working as implemented
in Ysbyty Alltwen and it was asked what
the Council could do in order to expand this method?
(j)
In response, the Head of Adults, Health and Well-being Department noted that the outcomes of the work of the Investigation was helpful to the Department and it offered
the type of support needed in order
to increase the momentum to
expand it. When specific obstacles
arose, naturally, the Area Manager for
Adults, Health and Well-being Department had their responsibilities along with the Senior Manager and the Head of Department and some matters were
referred to the Cabinet Member. If there were specific
elements that required a political decision, it was assured that they
would be brought up with Members.
(k) The need to employ a
receptionist was reiterated
and emphasised and there was concern
that the hard work of the Investigation and the Team would
be undermined.
(l)
In response, the Head
of Adults, Health and Well-being Department noted that he understood
why the comment was being made and
of course they had to be careful not to miss calls. However, from a managerial point of view, there was a need to look at the broader picture and the resources required for the new method of working,
before committing to this on a permanent
basis. He assured the members that he would
address the matter.
(m) In response to an enquiry regarding EMI beds, the Head of Adults, Health and Well-being Department noted that it was intended
to undertake a piece of work on this
subject. It was a must to make the best possible
use of what was available and to seek to ensure that the private sector was sustainable as much of the health and social services
staff's time was spent on trying
to help some of the homes. It was noted that the situation was currently difficult and it
would be necessary to consider what could
be done in terms of the best use of the Council's stock of homes. It was noted that the real pressures were related to nursing elements rather than residential elements. There would be a need to look objectively
at changing the balance within the homes and adapting the provision across the County.
(n) In response to an enquiry as to whether
this meant dual registration, the Head of Adults, Health and Well-being Department explained that the Health Board and
the local authority would have to collaborate
to seek to provide a service that was more intensive than what was currently being provided by the homes. This would involve
adapting the homes' registrations. The Regional Director - West, Betsi
Cadwaladr University Health
Board noted further that CSSIW had noted clearly that
there had to be an on call nurse within
the homes. Work was ongoing between the Health Board and the local
authority to consider a
model that was somewhat different in terms
of how to gain close contact between
the health provision on a local level
and home care provision for intensive patients
in order to avoid them having
to travel long distances to
receive service. Additionally, consideration had to be given to
the type of carers and specifically the career path for
promoting carers to become nurses.
Resolved: To ask the Cabinet Member for Adults,
Health and Well-being to accept the recommendations of the Scrutiny Investigation as outlined in points
4.1 - 4.10 of the report and
to submit an update on the action points and feedback
from the service users of the impact of the integrated working model to a meeting of this Scrutiny Committee in six months'
time.
Supporting documents: